Individual
MERRIA NOVIA DALIMONTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4612 S HARVARD AVE STE A, TULSA, OK 74135-2908
(918) 747-5565
(918) 747-5568
Mailing address
4612 S HARVARD AVE STE A, TULSA, OK 74135-2929
(918) 747-5565
(918) 747-5568
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
2842
OK
2084P0804X
Child & Adolescent Psychiatry Physician
2842
OK
363AM0700X
Medical Physician Assistant
Primary
2842
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200781730A
—
OK
01
—
L083271809
DRIVERS LICENSE
—
Enumeration date
06/29/2018
Last updated
07/25/2024
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